|
ER Visit (level 3)
|
$421.00 |
$421.00 |
$421.00 |
$770.04
|
|
ER Visit (level 4)
|
$644.50 |
$644.50 |
$644.50 |
$1,273.68
|
|
ER Visit (level 5, high severity)
|
$1,011.50 |
$1,011.50 |
$1,011.50 |
$1,820.02
|
|
Esophageal dilat s&i
|
$816.00 |
$816.00 |
$816.00 |
$581.10
|
|
Esophagoscopy flex remove fb
|
$1,593.00 |
$1,593.00 |
$1,593.00 |
$2,099.70
|
|
Esophagus motility study
|
$390.50 |
$390.50 |
$390.50 |
$1,289.20
|
|
Established Patient Office Visit (level 1)
|
$23.50 |
$23.50 |
$23.50 |
$120.25
|
|
Established Patient Office Visit (level 3)
|
$93.50 |
$93.50 |
$93.50 |
$183.00
|
|
Estradiol total
|
$330.50 |
$330.50 |
$330.50 |
$146.50
|
|
Estrogens total-sendout
|
$130.00 |
$130.00 |
$130.00 |
$96.20
|
|
Ethylene glycol -sendout
|
$72.00 |
$72.00 |
$72.00 |
$89.40
|
|
Eval aud funcj ea addl 15
|
$102.50 |
$102.50 |
$102.50 |
$85.80
|
|
Eval/fit voice prosthesis iii, st
|
$430.00 |
$430.00 |
$430.00 |
$356.00
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$49.50 |
$49.50 |
$49.50 |
$219.60
|
|
Evaluation heart device
|
$1,174.00 |
$1,174.00 |
$1,174.00 |
$2,368.17
|
|
Evaluation of speech fluency 92521
|
$319.00 |
$319.00 |
$319.00 |
$311.50
|
|
Evaluation psychiatric diagnostic
|
$190.00 |
$190.00 |
$190.00 |
$312.00
|
|
Evasc prlng admn rx agnt 1st
|
$2,276.50 |
$2,276.50 |
$2,276.50 |
$3,822.00
|
|
Evasc prlng admn rx agnt add
|
$2,276.50 |
$2,276.50 |
$2,276.50 |
$2,734.40
|
|
Evasc repair of iliac artery; endograft 34718
|
$2,852.50 |
$2,852.50 |
$2,852.50 |
$6,925.05
|
|
Evasc rpr a-ao ndgft 34701
|
$2,852.50 |
$2,852.50 |
$2,852.50 |
$5,230.40
|
|
Evasc rpr a-ao ndgft rpt 34702
|
$2,852.50 |
$2,852.50 |
$2,852.50 |
$4,670.40
|
|
Evasc rpr a-biiliac ndgft rptr
|
$2,852.50 |
$2,852.50 |
$2,852.50 |
$8,565.60
|
|
Evasc rpr a-iliac ndgft 34717
|
$2,852.50 |
$2,852.50 |
$2,852.50 |
$4,846.34
|
|
Evasc rpr a-unilac ndgft 34703
|
$2,852.50 |
$2,852.50 |
$2,852.50 |
$5,578.73
|
|
Evasc rpr a-unilac ndgft rpt
|
$2,852.50 |
$2,852.50 |
$2,852.50 |
$5,902.40
|
|
Evasc rpr ilio-iliac ndgft
|
$2,852.50 |
$2,852.50 |
$2,852.50 |
$6,931.00
|
|
Evasc rpr ilio-iliac rpt
|
$2,852.50 |
$2,852.50 |
$2,852.50 |
$8,996.13
|
|
Event monitor
|
$180.50 |
$180.50 |
$180.50 |
$242.65
|
|
Evoked auditory tst complete
|
$203.00 |
$203.00 |
$203.00 |
$344.68
|
|
Evoked oa emissions ltd
|
$172.00 |
$172.00 |
$172.00 |
$234.32
|
|
Evoked potentials auditory screening automated analysis
|
$286.50 |
$286.50 |
$286.50 |
$249.71
|
|
Evoked potentials upper limbs
|
$505.00 |
$505.00 |
$505.00 |
$908.54
|
|
Evoked potential visual not glaucoma
|
$265.50 |
$265.50 |
$265.50 |
$814.61
|
|
Ewhfo w/joint(s) cf
|
$649.46 |
$649.46 |
$649.46 |
$1,363.60
|
|
Ewho w/joint(s) cf
|
$438.84 |
$438.84 |
$438.84 |
$907.92
|
|
Ex arm/elbow tum deep < 5 cm
|
$4,357.50 |
$4,357.50 |
$4,357.50 |
$3,386.84
|
|
Exc abd les sc 3 cm/>
|
$4,802.00 |
$4,802.00 |
$4,802.00 |
$3,796.00
|
|
Exc abdl tum deep < 5 cm
|
$3,942.00 |
$3,942.00 |
$3,942.00 |
$3,386.84
|
|
Exc arm/elbo les sc >=3cm 24071
|
$5,758.00 |
$5,758.00 |
$5,758.00 |
$4,078.80
|
|
Exc arm/elbo les sc <3cm 24075
|
$4,357.50 |
$4,357.50 |
$4,357.50 |
$2,413.45
|
|
Exc back les sbq <3 cm 21930
|
$4,357.50 |
$4,357.50 |
$4,357.50 |
$2,676.58
|
|
Exc benign feenlm 3.1-4.0cm 11444
|
$3,195.50 |
$3,195.50 |
$3,195.50 |
$2,244.20
|
|
Exc benign feenlm >4.0cm 11446
|
$3,423.50 |
$3,423.50 |
$3,423.50 |
$3,386.84
|
|
Exc benign snhfg 3.1-4.0cm 11424
|
$3,254.50 |
$3,254.50 |
$3,254.50 |
$2,247.70
|
|
Exc benign tal 0.5 < cm 11400
|
$1,332.50 |
$1,332.50 |
$1,332.50 |
$827.40
|
|
Exc ben+marg excep skin tag feenlm <0.5cm 11440
|
$1,606.50 |
$1,606.50 |
$1,606.50 |
$914.34
|
|
Exc ben+marg excep skin tag feenlm 1.1-2cm 11442
|
$2,678.50 |
$2,678.50 |
$2,678.50 |
$1,135.40
|
|
Exc ben+marg excep skin tag feenlm 2.1-3cm 11443
|
$2,460.50 |
$2,460.50 |
$2,460.50 |
$2,061.19
|
|
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421
|
$1,716.50 |
$1,716.50 |
$1,716.50 |
$1,372.15
|
|
Exc ben+marg excep skin tag snhfg 2.1-3cm 11423
|
$2,812.50 |
$2,812.50 |
$2,812.50 |
$2,166.78
|
|
Exc ben+marg excep skin tag snhfg >4cm 11426
|
$4,136.00 |
$4,136.00 |
$4,136.00 |
$3,446.50
|
|
Exc ben+marg excep skin tag tal 0.6-1cm 11401
|
$1,196.50 |
$1,196.50 |
$1,196.50 |
$765.50
|
|
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403
|
$2,025.50 |
$2,025.50 |
$2,025.50 |
$1,247.50
|
|
Exc coccygl pr ulc flap clsr
|
$4,312.00 |
$4,312.00 |
$4,312.00 |
$4,332.25
|
|
Exc feenl mal+mrg 0.6-1 11641
|
$2,887.00 |
$2,887.00 |
$2,887.00 |
$973.71
|
|
Exc feenl mal+mrg 2.1-3 11643
|
$2,887.00 |
$2,887.00 |
$2,887.00 |
$2,101.45
|
|
Exc foot/toe tum subq < 1.5 cm 28043
|
$3,230.00 |
$3,230.00 |
$3,230.00 |
$3,230.00
|
|
Exc forearm les sc 3 cm/>
|
$5,758.00 |
$5,758.00 |
$5,758.00 |
$3,628.50
|
|
Exc forearm tum deep < 3 cm
|
$2,472.00 |
$2,472.00 |
$2,472.00 |
$2,149.50
|
|
Exc hand les sc < 1.5 cm
|
$4,357.50 |
$4,357.50 |
$4,357.50 |
$1,897.50
|
|
Exc hand tum deep < 1.5 cm 26116
|
$4,357.50 |
$4,357.50 |
$4,357.50 |
$2,271.01
|
|
Exchange biliary drg cath
|
$4,620.00 |
$4,620.00 |
$4,620.00 |
$3,909.56
|
|
Exchange blood transfusion newborn 36450
|
$877.50 |
$877.50 |
$877.50 |
$554.45
|
|
Exchange drainage catheter
|
$1,952.50 |
$1,952.50 |
$1,952.50 |
$2,205.50
|
|
Exchange nephrostomy cath
|
$3,114.00 |
$3,114.00 |
$3,114.00 |
$2,958.80
|
|
Exc hidradenitis peri/umb int 11470
|
$4,642.50 |
$4,642.50 |
$4,642.50 |
$3,386.84
|
|
Exc hip/pelv tum deep < 5 cm
|
$3,577.00 |
$3,577.00 |
$3,577.00 |
$3,386.84
|
|
Exc im tumor/back/flank/ < 5 cm 21932
|
$3,577.00 |
$3,577.00 |
$3,577.00 |
$3,398.50
|
|
Exc ischial pr ulcer w/ostc musc/myoq flap/skin 15946
|
$5,253.00 |
$5,253.00 |
$5,253.00 |
$4,017.60
|
|
Exc isch pr ulc skn flp ostc
|
$4,312.00 |
$4,312.00 |
$4,312.00 |
$4,144.66
|
|
Excise anal ext tag/papilla
|
$4,660.50 |
$4,660.50 |
$4,660.50 |
$1,710.00
|
|
Excise/repair mouth lesion
|
$1,889.50 |
$1,889.50 |
$1,889.50 |
$1,903.93
|
|
Excise subq tumor/abd wall <3 cm 22902
|
$4,357.50 |
$4,357.50 |
$4,357.50 |
$2,623.00
|
|
Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm
|
$1,606.50 |
$1,606.50 |
$1,606.50 |
$832.60
|
|
Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm
|
$2,232.00 |
$2,232.00 |
$2,232.00 |
$1,973.12
|
|
Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm
|
$1,762.50 |
$1,762.50 |
$1,762.50 |
$1,012.86
|
|
Excision benign lesion trunk/arms/legs > 4.0 cm
|
$4,357.50 |
$4,357.50 |
$4,357.50 |
$2,865.00
|
|
Excision of anal lesion(s)
|
$3,823.00 |
$3,823.00 |
$3,823.00 |
$3,786.00
|
|
Excision of vaginal septum 57130
|
$4,284.00 |
$4,284.00 |
$4,284.00 |
$3,762.53
|
|
Excision tumor soft tissue back/flank subcutaneous >= 3 cm
|
$5,758.00 |
$5,758.00 |
$5,758.00 |
$3,650.40
|
|
Exc les conjunctiva <1 cm
|
$1,132.00 |
$1,132.00 |
$1,132.00 |
$2,747.43
|
|
Exc malig feenl <0.5cm 11640
|
$2,887.00 |
$2,887.00 |
$2,887.00 |
$1,055.20
|
|
Exc malig feenl 1.1-2 11642
|
$2,887.00 |
$2,887.00 |
$2,887.00 |
$1,082.00
|
|
Exc malig feenl 3.1-4.0 11644
|
$3,282.00 |
$3,282.00 |
$3,282.00 |
$2,070.30
|
|
Exc malig feenl >4cm 11646
|
$3,854.00 |
$3,854.00 |
$3,854.00 |
$3,083.21
|
|
Exc malig snhfg 0.5cm or less 11620
|
$3,509.00 |
$3,509.00 |
$3,509.00 |
$1,210.30
|
|
Exc malig snhfg 0.6-1.0 cm 11621
|
$3,223.00 |
$3,223.00 |
$3,223.00 |
$973.71
|
|
Exc malig snhfg 2.1-3 cm 11623
|
$3,223.00 |
$3,223.00 |
$3,223.00 |
$1,917.33
|
|
Exc malig tal <0.5cm 11600
|
$1,131.50 |
$1,131.50 |
$1,131.50 |
$973.20
|
|
Exc malig tal 0.6-1.0cm 11601
|
$1,479.00 |
$1,479.00 |
$1,479.00 |
$832.60
|
|
Exc mal+marg tal 1.1-2 cm 11602
|
$1,069.50 |
$1,069.50 |
$1,069.50 |
$889.20
|
|
Exc mal+marg tal 2.1-3 cm 11603
|
$1,479.00 |
$1,479.00 |
$1,479.00 |
$1,131.50
|
|
Exc mal+marg tal 3.1-4 cm 11604
|
$1,358.00 |
$1,358.00 |
$1,358.00 |
$1,294.80
|
|
Exc neck tum deep < 5 cm
|
$5,758.00 |
$5,758.00 |
$5,758.00 |
$3,501.81
|
|
Exc/pilonidal cyst/sinus/simple 11770
|
$3,254.50 |
$3,254.50 |
$3,254.50 |
$3,386.84
|
|
Exc prtl bn phlnx toe
|
$2,146.50 |
$2,146.50 |
$2,146.50 |
$3,752.25
|
|
Exc sac pr ulc skn flp ostc
|
$4,312.00 |
$4,312.00 |
$4,312.00 |
$4,332.25
|
|
Exc sacral pr ulc skn flap
|
$4,312.00 |
$4,312.00 |
$4,312.00 |
$4,332.25
|
|
Exc shoulder tum deep < 5 cm
|
$4,652.50 |
$4,652.50 |
$4,652.50 |
$3,786.00
|
